| NPI | 1972074839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY WARREN VIOLAND Owner 443-538-5758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 2083S0010X Preventive Medicine, Sports Medicine |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2020-05-12 |